校内项目-音乐治疗

“2019 “

“M U S I C &

DEMENTIA Bufang Zhang

“C A T A L O G U E “

INTRODUCTION OF TEH CONCEPT

1

NEOTRIBE RESEARCH

3

REFLECTION & INITIAL INTERVENTION THINKING

7

PRE-PROGRAMME

11

THE FINAL PROJECT

13

1“

Music Therapy For Dementia

INTRODUCTION OF TEH CONCEPT

Music therapy is a creative arts therapy, consisting of a process in which a music therapist uses music and all of its facets—physical, emotional, mental, social, aesthetic, and spiritual—to help clients improve their physical and mental health.

The word ‘dementia’ describes a set of symptoms that may include memory loss and difficulties with thinking, problem-solving or language.

2“

INTRODUCTION OF TEH CONCEPT

As populations of developed nations age, so the number of cases of dementia increases.

As a way of helping care for and support people

with dementia, music has been shown to often have a dramatic effect.

We know that the auditory system of the brain is the first to fully funceffect

tion at 16 weeks, which means that you are musically receptive long before anything else. So it’s a case of first in, last out when it comes to a dementia-type breakdown of memory.

The power of music, especially singing, to unlock memories and kickstart the grey matter is an increasingly key feature of dementia care.

It seems to reach parts of the damaged brain in ways other forms of communication cannot.

TV Shouw

3“

WHY

I CHOOSE MUSIC AND DEMENTIA Folk music

Miracle in the life

I like to listen to folk music and sing in my leisure time.

So I usually notice some folk stars singer At the beginning of this term. I saw a TV show, in this program, one of my favourite folk singers participated in a charity which called “Miracle in the life” in Taiwan”.

This group is made of many music therapists for dementia patients. That inspired me if I could study in this aspect – Dementia and music.

4“ Choosing Process

MIND M AP

Golden Oldies Music for Life

Singing for the Brain

Play music

Singing for the Brain

Folk singer

Goups TV Show about music therapy

Lost Chord

Organize the activity for patients

Live music now

After the inspiration, I started to research some similar group in London. There are some tribes I find: Singing for the Brain, Music for Life, Lost Chord, Golden Oldies and Live Music Now.

MUSIC THERAPY & DEMENTIA

The word ‘dementia’ describes a set of symptoms that may include memory loss and difficulties with t h i n k i n g , problem-solving or language.

Therapied in hospital ALTERNATIVE CARE

Music therapy Music therapy is a creative arts therapy, consisting of a process in which a music therapist uses music and all of its facets

Family care Take part in other activities

In the end, I choose Singing for the Brain.

Because I notice most of their activities is about music therapy and old dementia patients. I also got the experience to live with my dementia relatives. Besides that, they have various and perfect service for the patients.

Singing for the Brain

Definition Dementia

H OW TO SE L E CT T H E N EOT R IB E 4 “

O B S E RVAT I ON I try to participate in this tribe. But I only get the opportunity to observe the situation at the beginning of their activity.

Fortunately, I find there is a lot of the video they made for recording the activity in the tribe.

And the therapist will try there best to reach these patients.

They said “we don’t want is musicians going into a room and standing behind a music stand. They have to be proactive and stimulating in order to keep the attention of this audience.”

The therapists will also engage and encourage someone with dementia to lead not just follow. Some of the patients will be the player or conductor

Be the leader

In most activity, I observe, in the beginning, only a few people joined in but after a while, everybody was singing along. In the process, they will sing, whistle, clap or tap their feet dance and do a various thing. It helps them, and their carers, to feel life is worthwhile. In this tribe. In this tribe, some symptoms of them are Alzheimer’s and some symptoms of them is Parkinson's disease

Reach these patients

5“

“ Oliver Sacks

THEORY

“MU S ICO PHI LI A

6“

I was recommended by the teacher the book of Oliver Sacks, which named Musicophilia.Oliver Sacks

Musicophilia Oliver Sacks

The aim of music therapy in people with dementia is broad — it seeks to address the emotions, cognitive, thoughts, and memories, the surviving “self” of the patient, to stimulate these and bring them to the fore. It aims to enrich and enlarge existence, to give freedom, stability, organization, and focus.

Musical sensibility, musical emotion, and musical memory can survive long after other forms of memory have disappeared. Music of the right kind can serve to orient and anchor a patient when almost nothing else can.

Besides that, he also mentions that music that helps patients with parkinsonism, for example, must have a firm rhythms character, but it need not be lyrics or intoned phrases. and interaction with a therapist. This information let me associate that some improvement that the tribe could make.

7“

R EFL E CTI O N & IN IT IAL IN T ERVE N TION TH IN K IN G Through the research and the theory. I find this tribe is more like a bridge or media for people to get together, and use music to create a relaxed, and cheerful environment. It not only focuses on curing their disease but takes care of their emotion. Another important point is that they make these patients feel they are worthwhile like the conductor and the keyboard player.

On the one hand, according to Oliver Sacks theory, different music rhythm would match different types of dementia patients. If the percussion could recorder the reaction of the patients. Maybe that could provide some information for the organise to adjust their music or the therapy.

On the other hand, the therapist may organise these patients to hold a concert. Let them obtain some achievement as a collectivity.

It will also a kind of a visible result of their effort for practising in the tribe.

Percussion They use

8 “ OBJ ECT I N THI S N E OT R I B E

It is easy to use When I visit the group I find maraca is the most popular percussion

Maraca

Xylophone

Join in the activity

There is enough space for the device

Easy to use

Maraca Maraca

C H O S I N G OB JE C T

Space for Popular devices

Jingle-ring

Bar chimes

Bells

“

Drums

In the activity they will choose some percussion instruments like maracas drums, jingle-rings for the patient to participent.

At first I think Maraca will be a pertential to develop in the following project.

“

Pre-programme 1

R ECORD T H E DATA 9 “ C U STOMIZE IN D IV ID U A L M U S IC TH E R A PY Embed a gyroscope sensor to record the beat that dementia patients follow. Using this way to collect data for individual patients, so that the carers and doctors could know their recent situation with music therapy. Besides that, the doctors could also adust patients’ music item to therapy.

Recording data

M U S I C P L A Y E R F O R I N D I V I D U A L D E M E N T I A

GYROSC OP E SEN SOR R e cor d t he da t a

Pre-programme 2 Research

1 0 “ THE SY M P TOM S OF DEMENTIA

Alzheimer's disease middle-stage symptoms: Increasing confusion and disorientation

– for example, getting lost,

10 Types of D ementia

or wandering and not knowing what time of day it is

Dementia is a term used to describe severe changes in the brain that cause memory loss. These changes also make it difficult for people to perform basic daily activities.

In most people, dementia causes changes in behavior and personality.

Alzheimer’s disease

Obsessive, repetitive or impulsive behaviour

Dementia with Lewy bodies

Delusions (believing things that are untrue) or feeling paranoid and suspicious about carers or family members

Dementia affects three areas of the brain: language, memory, decision-making

Dementia with Lewy bodies Other causes of dementia

Problems with speech or language (aphasia)

Huntington’s disease

Disturbed sleep

Normal pressure hydrocephalus

Changes in mood,

Wernicke-Korsakoff syndrome

such as frequent mood swings, depression and feeling increasingly anxious, frustrated or agitated

Dementia with Lewy bodies

Difficulty performing spatial tasks, such as judging distances

Vascular dementia

Seeing or hearing things that other people do not (hallucinations)

Mixed dementia Creutzfeldt-Jakob disease

Parkinson's signs and symptoms may include: Extracted Common Po in ts

“

Tremor A tremor, or shaking, usually begins in a limb, often your hand or fingers. You may a rub your thumb and forefinger back-and-forth, known as a pill-rolling tremor. Your hand may tremor when it's at rest.

Increasing confusion and disorientation Slowed movement Rigid muscles Loss of automatic movements Speech change to monotone

Slowed movement (bradykinesia). Over time, Parkinson's disease may slow your movement, making simple tasks difficult and time-consuming. Your steps may become shorter when you walk. It may be difficult to get out of a chair. You may drag your feet as you try to walk.

Rigid muscles. Muscle stiffness may occur in any part of your body. The stiff muscles can be painful and limit your range of motion.

Impaired posture and balance. Your posture may become stooped, or you may have balance problems as a result of Parkinson's disease.

Loss of automatic movements. You may have a decreased ability to perform unconscious movements, including blinking, smiling or swinging your arms when you walk.

Speech changes. You may speak softly, quickly, slur or hesitate before talking. Your speech may be more of a monotone rather than with the usual inflections.

Writing changes. It may become hard to write, and your writing may appear small.

Pre-programme 2 Research

11 “ THE F UNCT I ON OF MUSIC THERA P Y FO R DEMENTIA

"We've found compelling evidence that musical interventions can play a health care role in settings ranging from operating rooms to family clinics. But even more importantly, we were able to document the neurochemical mechanisms by which music has an effect in four domains: management of mood, stress, immunity and as an aid to social bonding.

management of mood

stress

immunity

Music can be powerful. Studies have shown music may reduce agitation and improve behavioral issues that are common in the middle-stages of the disease. Even in the late-stages of Alzheimer's, a person may be able to tap a beat or sing lyrics to a song from childhood. Music provides a way to connect, even after verbal communication has become difficult. reduce agitation

behavioral issues

A unique orchestra for people with dementia helped improve their mood and boost their self-confidence, according to researchers at the Bournemouth University Dementia Institute (BUDI) in Dorset, U.K. improve their mood

boost their self-confidence

Music can bring emotional and physical closeness.

In the later stages of dementia, patients often lose the ability to share emotions with caregivers. Through music, as long as they are ambulatory, they can often dance. Dancing can lead to hugs, kisses and touching which brings security and memories. hugs

Linda Maguire, lead author on the study wrote, “Musical aptitude and music appreciation are two of the last remaining abilities in patients with Alzheimer’s.” Because these two abilities remain long after other abilities have passed, music is an excellent way to reach beyond the disease and reach the person.

touching

kisses

social bonding

Pre-programme 2 Proposal

12 “

FROZEN G UI TAR As the research in neotribe, the activity and communication hold by neotribe are a bridge and social connections to the dementia patient. In addition, according to the research from the function of music therapy, I was inspired by the words “music is an excellent way to beyond the disease and reach the person.” These let me thought the disease like a block of ice, it freezes and isolates the feeling and consciousness from dementia patients.

So I think maybe I can use the ice to encase a heater, and there is some groove on the ice to imply audiences touch the ice, melting it through contact. In addition, there is an Arduino board link the heater and a guitar. When audiences play the instrument, the heater will start to be worm and melt the ice as well.

Play to active the heater to melt ice from inside

When you play, it will delay for 2 second (way to reach beyond the disease and reach the inside of dementia person)

Groove of hand form on ice let public touch (Contact , socail bonding, communicate)

Heater (The inside of dementia)

(Disease of the brain)

Record the data Frozen guitar

Reflection o f These two Pre -progra mme s

12 “

The first idea just is trying to solve the problem in the neotribe, but it still needs abundant research and suggestion from professional carer and doctor. It is a “Naive” stage in the design process. I think maybe I could develop this direction in following FMP. As for the second project, the metaphor among the ice, instrument, touching just too straightforward. Besides that, the whole installation seems a bit of ponderous. So, after these two ideas generating, I try to thinking of some design for debate and continue to do more research.

Fin d a n e w Dir e c t io n Instrument

IF I COULD MAKE A SP E CA I L I N ST R U ME NT

13 “ In the beginning, I really thought if I could make a special instrument that could represent dementia. Besides that, it could also transfer the concept of social bonding

Choosing a nwe way

and music therapy for dementia.

At the pre-programmed tutorial, once I show the picture of straws( as the left image) to translate one of my ideas.

My tutor said if I could associate this kind of straw structure with some problem from dementia patients’ brain.

So at the next stage, I set out to prepare this aspect research.

REsearch for dementia’s brain.

14 “

NE RVE F I BER TAN GLED IN A M A S S WAY A MY LOI D PROTEI N D E P O S I T I O N Biomarker, Alzheimer's disease, neurodegeneration, ocular, eye, retina ...... Reduction of optic nerve fibers in patients with Alzheimer disease identified ..... Early Abeta accumulation (amyloid protein deposition.) and progressive synaptic loss, gliosis, and tangle

RE A S O N F OR THE SYM P TO M S F O R M Toxic changes in the brain destroy this balance. This changes may accur years, even decades. Before the first sign of dementia. Researchers believe that this process involvetwo proteins, called beta-amyloid and tau which somehow become toxic to brain. It appears that abnormal tau accumulates, eventually forming tangles inside neurons. And beta-amyliod clumps into plaques which slowly build up between neurous. As the level of amyliod reaches a tipping point. There is rapid spread of tau through out the brain.

The vascualar system may fail to deliver sufficient blood and nutrients to the brain. The brain may lack the glucose needed to power its activity. Chronic inflammaiton set in as microglal cells fail to clear away debris and astrocytes react to distressed microglia. Eventually, neuons lose their ability to communicate.

15 “

M AT E R I A L CHOOSING The nerve fibres in the brain of dementia patients are somewhat tangled and broken, so I try to simulate the brains of people with dementia by some tangled or broken tube.

I choose this kind of flexible tubing. Because somehow, the grain of it is just like a brain’s surface. After I spray them to white, I am going to shape them in a mass, tangled way.

On the other hand, I tried to insert some cotton balls in the middle of the tube,which symbolizing protein precipitation in the brain such as beta-amyloid and tau.

Lin k fo r vid eo : https://vimeo.com/341091169

I N TERAC TI O N W I TH AU D I EN CE S

15 “

I also will leave some broken pipes extend from the installation. That would symbolize the broken and loss synaptic and neuron. In addition, these broken pipes can be designed for the interaction part.

When audience connect two pipe orifices , they will paly a kind of instrument sound or the words, sing from an dementia patients under an music therapy.

P R O J E C T A DY NAMIC V ID E O O F T H E F L OW I N G P IG M ENT S

TANGLED TU BI NG L I KE A PATI EN TS BR A I N & A I N STRU16 “ M ENT On the other hand, the image of this pipe entanglement is somewhat similar to the complex tubular structure at the back of the tuba. So, I also tried to shape this tangled pipe into a tubular instrument

16 “

Music produces a benign stimulus to the brains of people with dementia.

When the music is playing, the different part of the brain will be activated. You can see the active part from thermal map that the brain presents Through this kind of stimulation, the music can awaken their memories and feelings to some extent. So I thought whether it is possible to project a dynamic video of the colorful pigments flowing like the thermal map on the device. When the viewer connects the tube, the video is projected on brain—like pipes.

F O RM R E FE R E NCE

17 “

18 “ M AKI N G P ROCESS

F INAL

L ink for v id e o : https://vimeo.com/342518669

I m p rovemen t if I h ave chanc e I think the way I design for interaction could improve if I still have the time. I hope I could transform it into a wind instrument. When the audience blows these pipes, these pipes would make a sound like a tuba but not it, and the shape of the pipeline also could like a flute. There is some little hole on the pipes. When people plug these hole with their fingers, the “instrument� could change the pitch.

19 “

Reference https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5112261/ Oliver Sacks, (2011). Musicophilia. Pan Macmillan, 20 New Whar Road, London NI 9RR. p372-374 https://www.wnycstudios.org/story/91630-earworms https://www.wnycstudios.org/story/91569memory-and-forgetting https://forum.alzheimers.org.uk/ https://www.youtube.com/watch?v=tqrNEmuSCis https://www.mha.org.uk/files/8114/8181/0249/ MusicTherapyLeaflet_WEB2.pdf https://www.medicalnewstoday.com/articles/258383.php https://www.youtube.com/watch?v=0GXv3mHs9AU https://www.neurologyadvisor.com/topics/neurodegenerative-diseases/subjective-cognitive-declineassociated-with-tauopathy-and-global-%CE%B2-amyloid-burden/ https://www.whitworth.manchester.ac.uk/whats-on/exhibitions/upcomingexhibitions/beyond-dementia/

20 “

Tha nk you !